ultrasound-guided compression 1. compress for ____ with short rest 2. monitor ___

1. compress for 10-15secs with short rest 2. monitor distal perfusion

venous TOS 1. reduced ___ 2. bluish discoloration of the ___ 3. look for ___ development 4. evaluate what 4 veins

1. reduced venous outflow 2. bluish discoloration of the arm 3. look for collateral development 4. evaluate jugular, subclavian, innominate, and axillary veins

arterial TOS 1. reduced ___ 2. ___ of arm with numbness and tingling 3. look for (3) at rest and with various maneuvers

1. reduced arterial flow 2. paleness of arm with numbness and tingling 3. look for compression, stenosis, and flow changes

Miscellaneous Conditions/Testing Flashcards by lindsay crouse

what is a pseudo (false) aneurysm?

defect or hole in the arterial wall typically from trauma and often iatrogenic (hospital acquired)

does not involve all three layers of the arterial wall

How well did you know this?

Not at all

Perfectly

most common site for pseudoaneurysm

CFA

How well did you know this?

Not at all

Perfectly

pseudoaneurysm may present as a ___ or ___

prominent pulse
palpable mass

How well did you know this?

Not at all

Perfectly

pseudoaneurysms allow active blood flow outside the vessel but is contained by the ___ or ___

adventitia
surrounding perivascular soft tissue

How well did you know this?

Not at all

Perfectly

pseudoaneurysm

identify the ___ and document the ___ flow pattern

identify the neck
document the “to and fro” flow pattern

How well did you know this?

Not at all

Perfectly

3 treatment options for pseudoaneurysms

ultrasound-guided compression
ultrasound-guided thrombin injections
surgery

How well did you know this?

Not at all

Perfectly

ultrasound-guided compression

compress for ____ with short rest
monitor ___

compress for 10-15secs with short rest
monitor distal perfusion

How well did you know this?

Not at all

Perfectly

5 contraindications for ultrasound-guided thrombin injections

allergy to thrombin or bovine
infection of overlying area
ischemia of surrounding tissues
distal limb ischemia
very short and/or wide neck

How well did you know this?

Not at all

Perfectly

primary risk of ultrasound-guided thrombin injection

thrombin migration into the artery with subsequent thrombosis or embolization of thrombus distally

How well did you know this?

Not at all

Perfectly

3 contraindications of ultrasound-guided compression

inability to compress neck/stop flow
anticoagulation (blood thinners)
inability of the patient to tolerate

How well did you know this?

Not at all

Perfectly

what is an arteriovenous fistula (AVF)?

abnormal connection between the high-pressure arterial system and the low-pressure venous system

How well did you know this?

Not at all

Perfectly

AVF more central/close to heart has an increase potential for ___

cardiac failure

How well did you know this?

Not at all

Perfectly

AVF in peripheral vessels has the potential for ___

tissue ischemia

How well did you know this?

Not at all

Perfectly

A - inflow artery
B - very disturbed artery flow in the artery adjacent to the AVF tract
C - dependent upon the size of the fistula, flow pattern may return to normal distally
D - very high velocity flow in the AVF tract (aliased waveform)
E - outflow vein

How well did you know this?

Not at all

Perfectly

describe flow pattern for inflow artery of AVF

low resistance high-velocity
rapid systolic upstroke
diastolic flow
abnormal for a peripheral artery

How well did you know this?

Not at all

Perfectly

describe flow pattern of outflow vein of AVF

venous outflow proximal to the fistula becomes disturbed and pulsatile
arterial pressure and flow is transmitted into the vein

How well did you know this?

Not at all

Perfectly

3 types of thoracic outlet syndrome

neurogenic
venous
arterial

How well did you know this?

Not at all

Perfectly

most common type of TOS

neurogenic (95%)

How well did you know this?

Not at all

Perfectly

venous TOS

reduced ___
bluish discoloration of the ___
look for ___ development
evaluate what 4 veins

reduced venous outflow
bluish discoloration of the arm
look for collateral development
evaluate jugular, subclavian, innominate, and axillary veins

How well did you know this?

Not at all

Perfectly

arterial TOS

reduced ___
___ of arm with numbness and tingling
look for (3) at rest and with various maneuvers

reduced arterial flow
paleness of arm with numbness and tingling
look for compression, stenosis, and flow changes

How well did you know this?

Not at all

Perfectly

TOS

___ and ___ waveforms are used to detect changes with varied positions

PPG - index finger
Doppler - radial artery

How well did you know this?

Not at all

Perfectly

TOS waveform interpretation

normal -
abrnomal -

normal - no change
abnormal - attenuation or a change of the waveform during the maneuvers

How well did you know this?

Not at all

Perfectly

typical symptom of popliteal artery entrapment syndrome (PAES)

intermittent claudication with

dorsiflexion (gastrocnemius muscle contraction)
ankle is plantarflexed with resistance

How well did you know this?

Not at all

Perfectly

popliteal artery entrapment syndrome (PAES)

chronic, long term arterial compression may result in ___

chronic vascular microtrauma

How well did you know this?

Not at all

Perfectly

popliteal artery entrapment syndrome (PAES) chronic vascular microtrauma results in (5)

1. ateriosclerosis 2. stenosis 3. post-stenotic ectasia 4. aneurysm 5. thrombus

popliteal artery entrapment syndrome (PAES) PPG evaluates - Doppler evaluates -

PPG - toe Doppler - PTA or DPA

popliteal artery entrapment syndrome (PAES) resting waveforms are obtained and then repeated with ___

foot dorsiflexion

popliteal artery entrapment syndrome (PAES) look for (4) on imaging

1. wall changes 2. stenosis 3. thrombus 4. aneurysm formation

Buerger's Disease typically affects

small vessels in the upper and lower extremities

Buerger's Disease often presents with (3)

1. hand/foot ischemia 2. rest pain 3. ulceration

Takayasu's Arteritis is ___

intimal fibrosis and vascular narrowing on large arteries (aorta and its main branches)

Temporal Arteritis inflamed arterial segments are often ___ in diameter with a ___ thickening

inflamed arterial segments are often larger in diameter with homogenous thickening

Temporal Arteritis often described as an anechoic or hypoechoic ___ surrounding the vessel

anechoic or hypoechoic halo

Temporal Arteritis __ is considered the definite diagnostic "gold standard"

biopsy

Raynaud's Phenomenon as the spasm resolves, the area turns ___ (hyperemic) and the patient may experience a ___ sensation

are turns red burning sensation

Raynaud's Phenomenon severe disease may result in (2)

ulceration gangrene

primary Raynaud's 1. vasospasm ___ 2. ___ etiology

1. vasospasm only 2. unknown etiology

secondary Raynaud's vasospasm of secondary cause and (3)

tissue necrosis ulceration gangrene

arteries evaluated in penile duplex imaging

dorsal arteries cavernosal artery superficial and deep dorsal vein

___ disease can limit inflow into the penis

iliac artery disease

penile brachial index normal marginal abnormal

normal ≥ 0.75 marginal 0.65 - 0.74 abnormal < 0.65

baseline of penile duplex imaging 1. ____ artery AP diameter measured 2. spectral waveform is obtained to calculate (2)

1. cavernosal artery AP diameter measured 2. spectral waveform is obtained to calculate PSV and EDV

penile duplex imaging 1. injection of a vasodilator goes into ___ 2. measurements are repeated ___ 3. ___ flow velocity is obtained

1. lateral aspect and proximal shaft of penis 2. measurements are repeated 1-2mins 3. dorsal vein flow velocity is obtained

penile duplex imaging post injection 1. diameter of ___ should increase 2. flow resistance should change from ___ to ___ 3. PSV should increase ___ 4. ___ velocities should not increase

1. diameter of cavernosal arteries should increase 2. flow resistance should change from high to lower 3. PSV should increase >30cmsec 4. dorsal vein velocities should not increase

penile duplex imaging 1. increase in dorsal vein velocities are suggestive of ___ 2. normal - 3. abnormal -

1. venous leak 2. normal <3cm/sec 3. abnormal >20cm/sec

risk of penile duplex imaging

priaprism - erection lasting more than 4 hours

trauma 1. ___ injuries can result from blunt or penetrating trauma 2. may result in ___ or transection of the vessel 3. may or may not be ___ pulses depending on severity

1. arterial injuries 2. may result in intimal tear/dissection 3. may or may not be distal pulses

treatment of compartment syndromes

fasciotomy

Transcutaneous Oximetry (TcPO2) electrode heats the skin to ___ to increase blood flow

45°C

Transcutaneous Oximetry (TcPO2) assesses ___ and determines ___

assesses wound healing determines amputation level

Transcutaneous Oximetry (TcPO2) reference site is ___

upper lateral chest

Transcutaneous Oximetry (TcPO2) takes ___ to obtain PO2 readings

15-20 minutes

Transcutaneous Oximetry (TcPO2) interpretation adequate healing potential borderline healing potential poor healing potential

adequate healing potential >50mmHg borderline healing potential 30-50mmHg poor healing potential <30mmHg

laser Doppler determines ___

microvascular blood volume

laser Doppler cuff is inflated to ___ and then slowly deflated

100mmHg

laser Doppler ___% drop in volume indicator is required for SPP to be measured

< 0.1%

laser Doppler interpretation SPP for adequate healing potential SPP for poor healing potential

> 40mmHg - adequate healing < 30mmHg - poor healing

what is a hydrophone?

microphone that detects sound waves underwater

hydrophone is used in the development of ultrasound equipment to include ___

testing power and intensity levels generated by the ultrasound beam as it passes through the medium

Allen test normal color should return in

< 10 seconds

pre-operative arterial mapping 1. determines the (3) of a vessel for use as a ___ 2. determines suitability of the upper extremity arterial system for ___

1. determines patency, size, and suitability of a vessel for a use as a surgical bypass 2. determines suitability of the upper extremity arterial system for dialysis access AV fistula

radial artery mapping determines

suitability for use as a graft for coronary artery bypass

radial artery testing ___ is used to assess the patency of the palmar arch

Allen test with PPG if abnormal, do not proceed - radial artery compromised

radial artery mapping measure the diameter of the radial artery, should be ___

>2mm

upper extremity arterial system for dialysis access AV fistula is typically assessed at the same time as ___

venous mapping for access creation

epigastric artery is used to identify ___

best arterialized muscle segment for TRAM flap breast recontruction

what is the terminal branch of the internal mammary artery

deep superior epigastric artery

internal mammary artery is also known as

internal thoracic artery

internal mammary artery arises from the ___ and descends posterior to the ___

arises from the subclavian artery descends posterior to the upper 6 ribs

internal mammary artery determines a normal or adequate vessel for (2)

1. use as a recipient site for TRAM flap breast reconstruction 2. use as a graft to the left anterior descending artery (LAD) in coronary bypass grafting

pre-operative venous mapping determines (2)

1. suitability of a specific vein for use as an extremity or coronary bypass conduit 2. adequate outflow for the creation of a native (autogenous) dialysis access fistula or dialysis graft

pre-operative venous mapping GGS and SSV are used for

peripheral /coronary artery bypass

pre-operative venous mapping cephalic and basilic vein are used for

peripheral/coronary artery bypass dialysis arteriovenous access creation

pre-operative venous mapping subclavian, axillary, brachial veins are used for

dialysis arteriovenous access creation

which vein is larger - basilic or cephalic

basilic vein is larger

pre-operative venous mapping diameter measurements should be

2-3mm

Miscellaneous Conditions/Testing Flashcards

(77 cards)